Journal of Autism and Developmental Disorders, Vol. 31, No. 2, 2001
Children’s Attitudes and Behavioral Intentions Toward a Peer with Autistic Behaviors: Does a Brief Educational Intervention Have an Effect? Karen F. Swaim1 and Sam B. Morgan1,2
This study examined children’s ratings of attitudes and behavioral intentions toward a peer presented with or without autistic behaviors. The impact of information about autism on these ratings was investigated as well as age and gender effects. Third- and sixth-grade children (N = 233) were randomly assigned to view a video of the same boy in one of three conditions: No Autism, Autism, or Autism/Information. Children at both grade levels showed less positive attitudes toward the child in the two autism conditions. In rating their own behavioral intentions, children showed no differences between conditions. However, in attributing intentions to their classmates, older children and girls gave lower ratings to the child in the autism conditions. Information about autism did not affect ratings of either attitudes or behavioral intentions as ascribed to self or others. KEY WORDS: Autism; autistic disorder; attitudes; behavioral intentions.
give us not only a better understanding of children’s attitudes toward peers with autism but also a basis for fostering in children more acceptance of these peers with whom they may be having daily contact. Research has demonstrated that children with various disorders are often confronted with negative attitudes from their peers (e.g., Friedrich, Morgan, & Devine, 1996; Stoneman, 1993). Based on Weiner’s attribution theory, one would predict, however, that children’s attitudes toward the affected peer would be more positive if they view the problem as being beyond rather than within the peer’s control (Weiner & Graham, 1984). For example, if a disorder is explained as a handicapping condition over which the child has no control, then one would expect that children would show more positive attitudes toward the affected peer than they would if no such explanation were provided. Research findings involving different disorders, however, have failed to provide consistent support for this hypothesis. Sigelman (1991) found that provision of low-responsibility information reduced children’s tendency to hold an obese girl or wheelchair-bound girl responsible for her condition; although such informa-
INTRODUCTION The current trend toward full inclusion of children with autism in school programs with normally developing peers has raised some issues that are worthy of study (Kasari, Freeman, Bauminger, & Alkin, 1999; Mesibov & Shea, 1996). In addition to unresolved issues regarding the educational benefits of such inclusion, some questions emerge concerning the degree of acceptance shown by normally developing children toward a peer with autism. In the present study we addressed some of these questions by examining factors that may influence children’s initial attitudes and behavioral intentions toward a peer who exhibits autistic behaviors. We were especially interested in the question of whether these attitudes and behavioral intentions are affected by explanatory information about autism. Information gained through such research may 1 2
The University of Memphis, Memphis, Tennessee. Address all correspondence to Sam B. Morgan, Department of Psychology, The University of Memphis, Memphis, Tennessee, 38152; [email protected]
195 0162-3257/01/0400-0195$19.50/0 © 2001 Plenum Publishing Corporation
196 tion improved their liking of the wheelchair-bound girl, it did not alter their liking for the obese girl. Sigelman concluded that liking was more related to the nature of the condition than to its perceived cause. Potter and Roberts (1984) presented children with written vignettes of a peer with epilepsy or diabetes and found that children given explanatory information perceived the peer as less attractive than did children who received only descriptive information. Two studies using methodology similar to that used in the current experiment also yielded results showing that information about the disorder had limited positive, or even negative, effects on children’s attitudes or behavioral intentions. Friedrich et al. (1996) found that information about Tourette disorder failed to improve children’s attitudes and behavioral intentions toward a peer showing symptoms of the disorder in video presentations. Siperstein and Bak (1980) found that children who had been exposed to a blind child through video and then given lessons about blindness showed more positive attitudes but more negative behavioral intentions toward the child than did peers who experienced no lessons. These authors proposed that the lessons may have resulted in more negative behavioral intentions because they accentuated the differences between the blind child and sighted child. Recent research findings have suggested that children may report positive intentions toward children with certain types of handicaps because it is “socially desirable” to do so; that is, they may present themselves through their ratings to be consistent with their conceptions of how “good boys” and “nice girls” should respond to someone with a disability. In a study by Morgan, Bieberich, Walker, and Schwerdtfeger (1998), children showed highly positive behavioral intentions toward a peer in a wheelchair, but their ratings of their classmates’ intentions were much less positive, which suggests “social desirability” might have influenced their own ratings. Friedrich et al. (1996) gave a similar interpretation to their finding that children rated their classmates as being less accepting than themselves of a child with identified symptoms of Tourette disorder. Like children with Tourette disorder, children with autism appear to be at risk for rejection by peers, at least upon initial contact. Based on a study of parents’ perceptions of attitudes toward their autistic child, Gray (1993) concluded that most parents perceived autism to be a stigmatizing condition that is frequently met with hostile, insensitive, and stereotypical reactions because of the general public’s relative lack of under-
Swaim and Morgan standing of autism, the normal physical appearance of most children with autism, and the unusual and sometimes disruptive behavior associated with the disorder. It seems likely, then, that schoolchildren might similarly react with misunderstanding and lack of acceptance upon first contact with a child showing autistic features. In the present study we examined factors affecting children’s attitudes and behavioral intentions toward a peer presented, via video, with autistic behaviors. In view of findings with other disorders showing that explanatory information does not necessarily have a positive impact, we were especially interested in whether these attitudes and intentions were influenced by information providing an explanation of autism. The video presentation allowed the participants to see the child engaging in autistic behaviors as well as to hear speech associated with autism. Through such presentation we felt that the initial reactions evoked by such behaviors could be more validly assessed. We also wanted to assess children’s responses on two different types of measures—one assessing stereotypic attitudes and the other behavioral intentions. Gottlieb and Gottlieb (1977) proposed that certain measures assess the cognitive component of attitudes as reflected through the positive or negative features that children may ascribe to a person with a disability or disorder. However, measures of behavioral intentions tap the conative component of attitudes—that is, the degree to which children are willing to commit their own behavior toward acceptance or rejection of a person with a disability. In the current study we used the Adjective Checklist (Siperstein & Bak, 1977) to assess stereotypic attitudes and the Shared Activities Questionnaire (SAQ; Morgan, Walker, Bieberich, & Bell, 1996) to assess behavioral intentions, that is, children’s willingness to engage in activities with the target child as reflected by ratings on subscales representing three activity areas (i. e., general social, academic, and active recreational). To explore a possible social desirability effect, we had the children rate not only their own behavioral intentions (SAQ-Self) toward the child in the video but also their perception of their classmates’ behavioral intentions (SAQ-Others) in the three activity areas. Some previous research on children’s attitudes and behavioral intentions toward peers with handicapping conditions has shown age and gender to be significant variables (Ryan, 1981). Morgan and Wisely (1996) found that elementary school children’s ratings of both attitudes and behavioral intentions toward a child in a wheelchair became significantly less positive with age.
Attitudes and Behavioral Intentions Bell and Morgan (2000) found that provision of medical information had a positive effect on attitudes toward an obese peer only for younger children and a negative effect on willingness of older children to share academic activities with the peer. We wanted to examine possible gender differences because some studies have reported that girls express more positive attitudes about disability than boys (e.g., Siperstein, Bak, & Gottlieb, 1977; Voeltz, 1980). Further, because the target child in the present study was a boy, we wanted to see if his gender alone differentially affected the responses of boys versus girls. We examined third- and sixth-grade children’s attitudes and behavioral intentions toward the same peer presented under three conditions: (a) No Autism, (b) Autism, or (c) Autism plus Information (Autism/ Info). The following questions were addressed: 1. Do children show less positive attitudes toward a peer presented with autistic behaviors than toward the same peer presented without such behaviors? 2. Do children show less willingness to engage in certain types of activity (i.e., social vs. academic vs. recreational) with a peer exhibiting autistic behaviors than with the peer not exhibiting such behaviors? 3. Do children view their classmates’ willingness to share activities as more negatively influenced than their own by the presence of autistic behaviors in a peer? 4. Does information that explains autism have a positive effect on children’s attitudes and behavioral intentions toward a peer presented with autistic behaviors? 5. Do older children (sixth graders) differ from younger children (third graders) in their attitudes and behavioral intentions toward a peer with autistic behaviors? 6. Do boys differ from girls in their attitudes and behavioral intentions toward a peer with autistic behaviors?
METHOD Participants Participants were 233 children (112 third- and 121 sixth-graders) from regular classes in two neighboring public schools in a predominantly middle-class suburb of a large metropolitan area. Children were recruited through a parental informed consent form sent home from school with each eligible child. Because we wanted to assess, as much as possible, naïve or first reactions to autistic behaviors by children who had no
197 knowledge of autism, we drew participants from classes that did not include children with autism. We also screened each child regarding his or her knowledge of autism. None of the participants was able to demonstrate familiarity with autism by writing a reasonably correct definition of autism on the screening form. The sample consisted of 116 boys (49.8%) and 117 girls (50.2%) with a racial distribution of 93.6% White and 6.4% Black. Children at each grade were randomly assigned (stratified according to gender and race) to one of three conditions: (a) No Autism (n = 78), (b) Autism (n = 77), (c) Autism/Info (n = 78). The mean age was 9.12 years for third graders and 12.02 years for sixth graders. Chi-square analyses revealed no significant differences with regard to school attended, gender, or racial distribution of the participants in the three conditions both within grades and between grades. Further, ANOVAs at each grade level revealed no significant differences in age from condition to condition. Procedure The children, who had been assigned to one of the three experimental conditions, were escorted in groups of approximately 10 from their classrooms to a private room furnished for comfortable viewing of a large television set. The children were then given these oral instructions: We are going to show you a videotape, and then we will ask you to answer some questions about the video. Watch the child on the video and listen carefully to what the video says. Do not talk to your neighbor until after we are completely done with the tape and the questions about it. Does anybody have any questions?
Directions were repeated as necessary to assure that each child understood what was expected of him or her. The group then viewed the videotape corresponding to one of the three experimental conditions. Following the video, each child was given a packet containing the demographic and screening form, Adjective Checklist, Shared Activities Questionnaire (SAQ-Self), a modified Shared Activities Questionnaire (SAQ-Other), and a Similarity Rating Form (SRF). Then these oral instructions were given: Please answer the questions honestly. Your answers should be based on how you feel and not how your best friend or your neighbor feels. Your answers are private and will not be seen by your friends, teacher, or parents. I am going to read the directions and questions to you. Please follow along with me and don’t get ahead of the group. If you need something repeated or have any questions, raise your hand. Do you have any questions before we begin?
198 Again, directions were clarified as necessary until each child indicated understanding of what was expected of him or her. Children in all conditions had all directions, questions, and statements in the packet read to them by a member of the research team. The difference between the instructions for the SAQ-Self and the SAQ-Others was emphasized. The SAQ-Self was introduced with the statement, “Read each question and circle the face and answer that shows how you feel about doing each of these things with Robby,” while the SAQ-Others was introduced with the statement, “Read each question and circle the face and answer that shows how you think your classmates would feel about doing each of these things with Robby. So this is a little bit different. This time you circle the face and answer that shows how the other kids in your class would feel about Robby.” Children were closely monitored to prevent any sharing of information regarding their responses. Upon the group’s completion of all questionnaires, the packets were collected from the children, and the experimenters checked each child’s questionnaires to ensure that each question had been answered. Video Presentation A 12-year-old boy, the sibling of a child with autism, was recruited to appear in three videos playing the part of a child who either did or did not show symptoms of autism. The boy was quite familiar with autistic behaviors through his experience with his sibling and other children with autism. In all conditions, he was seated at a table and playing with a puzzle. In the Autism and Autism/Info conditions, he displayed autistic symptoms every few seconds in the form of gaze aversion, rocking in his chair, and hand flapping; in interaction with a female he responded with echolalia. To evaluate the accuracy with which the autistic symptoms were displayed, the authors had the videotapes reviewed by four individuals familiar with the diagnostic features of autism: the parent of a child with autism, a school psychologist, a child clinical psychologist, and an advanced graduate student in child clinical psychology who worked each week with children with autism. The four reviewers agreed that the child actor had accurately portrayed symptoms associated with autism. Three separate videos, corresponding to the three experimental conditions, were used. For the No Autism condition, the child actor behaved “normally,” that is, he displayed no autistic behaviors and interacted ap-
Swaim and Morgan propriately with a female, while a voice-over delivered the message described in the next section. For the Autism condition, the child actor displayed autistic behaviors and showed interactions characteristic of a person with autism while the voice-over delivered the same message as that for the No Autism condition. For the Autism/Info condition, the child actor showed the same autistic behaviors as in the Autism condition (the same video portion of tape was used) while the voiceover delivered the script including the information concerning autism. The No Autism and Autism videos were each 1 minute 15 seconds long, while the Autism/Info video was 2 minutes 15 seconds long. Message Content A verbal message, delivered via voice-over on videotape by an adult female, was similar for each condition with the exception of the presence or absence of information describing autism. Children in the No Autism and Autism conditions received the same message, which did not include any specific information about autism. Children in the Autism/Info condition received that message along with a brief explanation of autism. For the No Autism condition the script was as follows: This is Robby. He is about the same age as you, and he goes to school like you do. Robby’s family lives in a town called Woodmont. Woodmont is a mediumsized town that has schools, churches, shopping malls, movie theaters, libraries, and most of the other things towns have. Robby and his family go to the zoo, the shopping mall, and church. During the summer, they sometimes go to a park or a lake to enjoy being outdoors. Robby also likes to eat at McDonald’s. [Voice-over ends. Adult female walks into view, toward Robby, and says “Hi Robby, what are you doing, working on a puzzle?” Robby responds, “Yeah. It’s one I got at the mall. It’s got sharks and fish and stuff on it.” Adult female replies, “Do you want to go play with one of your friends when you’re done with the puzzle?” Robby responds, “Sure! That sounds like fun!” Adult female states, “Well, it looks like you’re doing a real good job, Robby.” Robby replies “Thanks.” Adult female walks out of view, and voiceover resumes.] Robby likes to do many of the things you do. He likes to watch television, play with puzzles and put model cars together. Robby lives in Woodmont now, but his family might be moving to your neighborhood soon. If they do, he’ll be starting at your school and may be in your class.
The scripts for the Autism and Autism/Info conditions were identical to the No Autism script except for the middle segment involving the interaction be-
Attitudes and Behavioral Intentions tween the child and the adult and, in the Autism/Info condition, the addition of the brief explanation for the autistic behaviors. This middle segment for the Autism and Autism/Info conditions was as follows: [Voice-over ends. Adult female walks into view, toward Robby, and says “Hi Robby, what are you doing, working on a puzzle? Robby responds, “Hi Robby working on puzzle” while showing gaze aversion and stereotypic hand movements and rocking. Adult female replies, “Do you want to go play with one of your friends when you’re done with the puzzle?” Robby responds, “Friend done with puzzle.” Adult female states, “Well, it looks like you’re doing a real good job, Robby.” Robby replies “Good job Robby.” Adult female walks out of view, and voice-over resumes.]
The additional information in the Autism/Info condition was as follows: Robby has autism, which means that there’s something wrong with his brain that makes it hard for him to look at other people and talk to them. When he talks, he sometimes repeats what was said to him instead of answering the question. And sometimes it seems like he can’t hear, even though he can. Sometimes Robby waves his hands around, or spins around or rocks back and forth, or bounces up and down in his chair. He may even hit or bite himself or other people or things. And Robby has a hard time changing activities, going from doing one thing to doing something else. Robby doesn’t mean to be different or hard to get along with. He’s not trying to make trouble; he does these things because he has autism. But people with autism can learn to do many of the things that people without autism can do, like talk to and play with other people, go to school, read and write, and even get jobs or go to college when they grow up. They just need some help to learn how to do these things.
Measures Following the videotape presentation, the children in each condition were asked to complete a demographic and screening form and the following four questionnaires: the Adjective Checklist (Siperstein, 1980; Siperstein & Bak, 1977); the SAQ-Self (Morgan et al., 1996); the SAQ-Others; and the Similarity Rating Form (SRF). The Adjective Checklist The Adjective Checklist (Siperstein, 1980; Siperstein & Bak, 1977) has been used extensively in research on the measurement of elementary school children’s attitudes toward people with handicaps. It includes a list of 32 adjectives; half of the adjectives have a positive value (e.g., smart, neat) and half have a negative value (e.g., dumb, sloppy). Each rater en-
199 dorses all the adjectives that best describe the target child. The checklist is scored by subtracting the total negative adjectives endorsed from the total positive and adding a constant of 20; scores may range from 4 to 36, with scores above 20 indicating more positive and scores below 20 indicating more negative attitudes. Factor analysis confirmed construct validity for positive or negative value of the adjectives, and a coefficient alpha of .81 indicated acceptable internal consistency (Siperstein, 1980). The coefficient alpha for the current sample was .91. Concurrent and construct validity, based on a sample of 233 elementary school children, was examined through Pearson correlations with the SAQ (Morgan et al., 1996). These correlations, all of which are significant (p < .01), were .46 for the Total Score, .45 for the General Social factor score, .41 for the Academic factor score, and .36 for the Recreational factor score. While these correlations suggest a strong relationship between stereotypic attitudes and behavioral intentions, they also suggest that they represent different constructs, as proposed by Gottlieb and Gottlieb (1977). Shared Activity Questionnaire (SAQ) The SAQ is an experimental scale developed to assess willingness of an elementary school child to engage in certain activities with a target child (Morgan et al., 1996). The SAQ includes 24 items (estimated to be at the second- to third-grade reading level) covering three broad activity areas: General Social (e.g., “Eat lunch next to Robby at school”), Academic (e.g., “Work arithmetic problems in class with Robby”), and Active Recreational (e.g., “Go to a ball game with Robby”). Below each item are line drawings of faces with corresponding responses: “yes” with a smile, “maybe” with a neutral expression, and “no” with a frown. The subject circles the answer that shows how he or she feels about sharing each activity with the target child. Each item is scored as 3 (yes), 2 (maybe), and 1 (no). A total score can be obtained as well as a score for each of the three activity areas, with higher scores reflecting more willingness to share in the activity. The original version of the SAQ, in which a subject rates his or her own willingness to engage in activities with a peer with autism, is referred to as the SAQ-Self. In addition to the SAQ-Self, a modified version, the SAQ-Others, was used. The modification pertains to the instructions given to the child rather than to the instrument itself. Children were asked to respond to the SAQ-Others items as they believed that their classmates would. This modification was used to assess the pos-
200 sibility that the children’s responses to the SAQ-Self were biased in an attempt to appear socially desirable. A confirmatory factor analysis of the SAQ yielded a comparative fit index for the three-factor solution of .95 (Morgan et al., 1996). The mean item loading for the three factors were as follows: General Social, .69 (with a range of .56–.76); Academic, .68 (range .54–83); Recreational, .73 (range .69–.81). Internal consistency reliability, as reflected by coefficient alpha, was .95 for the SAQ Total Score, .88 for the General Social factor score, .87 for the Academic factor score, and .90 for the Recreational factor score. Comparable internal consistency coefficients were obtained with the SAQ-Others with the current sample: .91 for the Total Score, .82 for the General Social factor score, .78 for the Academic factor score, and .81 for the Recreational factor score. Similarity Rating Form Following the administration of other measures, the Similarity Rating Form (SRF) was presented as a manipulation check. The single question, “How much like other kids in your class is Robby?” was presented along with a 4-point Likert scale which had no neutral option. The four answer choices were 1 (very different from other kids in my class), 2 (sort of different from other kids in my class), 3 (sort of the same as other kids in my class), and 4 (very much the same as other kids in my class). RESULTS For all results the initial analysis was a factorial ANOVA. Follow-up tests on significant findings consisted of univariate F tests, t tests, and the StudentNewman-Keuls procedure (alpha = .05) for multiple comparisons of means. Manipulation Check on Perception of Autistic Symptoms As a manipulation check, a 3 (Autism Condition) × 2 (Grade) × 2 (Respondent Gender) factorial ANOVA was used to determine if the expected differences emerged on the SRF. A highly significant main effect was found for condition, F (2, 221) = 8.69, p < .001, but no other main effects or significant two-way or three-way interactions were found. Follow-up comparisons revealed that children in the No Autism condition (M = 2.71) rated the target child as more similar to their classmates than did children in the Autism (M = 2.16) and Autism/Info (M = 2.24) conditions, which did not differ significantly from one another.
Swaim and Morgan Adjective Checklist Table I presents the means and standard deviations for children’s scores on the Adjective Checklist, SAQSelf, and SAQ-Others at each grade level. A 3 (Autism Condition) × 2 (Grade) × 2 (Respondent Gender) factorial analysis of variance (ANOVA) revealed highly significant main effects for autism condition, F (2, 221) = 23.99, p < .001, and grade, F (1, 221) = 9.06, p < .005. A follow-up univariate F test revealed highly significant differences between conditions on the Adjective Checklist, F (2, 232) = 23.60, p < .001. Follow-up tests indicated that children rated the target child in the No Autism condition (M = 31.55) more favorably than in the Autism (M = 26.74) and Autism/Info (M = 25.08) conditions, which did not differ significantly from one another A t test, t (231) = 2.57, p = .011, revealed that, across conditions, students in the third grade (M = 28.95) rated the target child more favorably than children in the sixth grade (M = 26.73). Figure 1 illustrates the mean Adjective Checklist ratings for the three conditions at the two grade levels.
Shared Activity Questionnaire SAQ-Self. A 3 (Autism Condition) × 2 (Grade) × 2 (Respondent Gender) × 3 (Activity Area) mixed ANOVA, with the three SAQ activity areas as the within-subjects factor, revealed no significant main effects or interactions related to autism condition for SAQ-Self activity area scores. This result indicates that children showed no differences from condition to condition in preferences for activities to be shared with the target child. SAQ-Others. A 3 (Autism Condition) × 2 (Grade) × 2 (Respondent Gender) × 3 (Activity Area) mixed ANOVA, with the three SAQ-Others activity areas as the within-subjects factor, yielded highly significant main effects for condition, F (2, 221) = 7.71, p = .001, and for grade, F(1, 221) = 35.86, p < .001. Further, a significant two-way interaction was found between condition and grade, F (2, 221) = 3.36, p < 05. A significant main effect was found for activity area, F (2, 442) = 15.79, p